HomeMy WebLinkAboutMortgage_Lundeen�.
STATEMENT OFMORTGAGE OR CONTRACTINDEBTEDNESS
' FOR DEDUCTION FROM ASSESSED VALUATION
's M� J $ta[e Form 437 W (R5 / 4-03) . . . '
� P�esaibe0 by Department of Local Govemment Finance
Coun Township Year
/
INSTRUCTIONS: ,fUN O i��@6a�
To be filed in person or by mail wifh the County Auditor ol the county where the property is located.
Filing Oates: 1) Real Property: During the 12 months 6efore May 11 of the year the deduction is to be eRective. �
2J Mobile Homes assessed under IC 6-1.1-7: Between January 15 and March 2 0/ the yea�ij'e�deddc��s to 6e effective.
See reverse side for additional instructions and quali�cations. pIBSON COUNTY AUBIiOR
Taxing
Assessed value oi real property as of
March 1, wrrent year
no, what is his / her exact share of
on reverse side)
Key number / legal description Record number Q�
D i � ^ � � � � Page number ' D�
0
MoRgage / Contrad indebtedness unpaid as of Is the applirant the sole legal or
March t, currenl year owner? ❑ Yes ❑ No
If owned with someone other than spouse, indicate with whom.
T/I�—�
If name on
than lhat of applicant, indicate
mortgagee or contrad seller
Address of mortgagee or contracl seller (number and streef, city, state, ZIP
Name of assignee or other owner or holder of mortgage
Address oi assignee (number and sUeet, city, state, ZIP
� 78 -6Q a-
Is the property in question:
❑ Real Property ❑ Mobile Home QC 61.1-�
Does applicant own property in any olher I If yes, what county? What Taxing Disirict? Has this dedudion been requested on
county in Indiana? property for current year? � Yes❑ No
Deduction approved in the amount of:
20
Signature
COUNTY AUDITOR
zo U b_ I 20 � I zo _ I, ^ zo
P P i�fi��
County Auditor
20
Date
zo
We certify under the penalty of perjury that fhe above and foregoing information is true and correc[ and that the applicants was / were
@Shlent.�f Indiana and owner of the aforementioned property on March 1, 20
full
of
Person authorized by duly executed Power of Attorney
or by IC 6-7.1-12-.07 �
Address of authorized person
�6b0